How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $67.61 Median $602.56 Typical High $8,317.64 | Facility | None | $67.61 | $602.56 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $281.84 Typical High $524.81 | Professional | None | $54.95 | $281.84 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $204.17 Typical High $331.13 | Professional | None | $45.71 | $204.17 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $69.18 Median $295.12 Typical High $489.78 | Professional | 50 · Both sides | $69.18 | $295.12 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $69.18 | Professional | None | $45.71 | $51.29 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $147.91 Typical High $478.63 | Professional | None | $44.67 | $147.91 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $354.81 | Professional | None | $239.88 | $281.84 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $489.78 | Professional | None | $380.19 | $478.63 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $70.79 Median $89.13 Typical High $562.34 | Facility | None | $70.79 | $89.13 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $426.58 | Professional | None | $53.70 | $63.10 | $426.58 |
Sentara Setting Facility Modifier None Typical Low $42.66 Median $91.20 Typical High $10,232.93 | Facility | None | $42.66 | $91.20 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $758.58 | Professional | None | $295.12 | $398.11 | $758.58 |
United Setting Facility Modifier None Typical Low $204.17 Median $1,023.29 Typical High $2,398.83 | Facility | None | $204.17 | $1,023.29 | $2,398.83 |
United Setting Professional Modifier None Typical Low $43.65 Median $213.80 Typical High $537.03 | Professional | None | $43.65 | $213.80 | $537.03 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $42.66 Typical High $173.78 | Professional | 52 · Reduced service | $27.54 | $42.66 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.98 Typical High $69.18 | Professional | 53 · Discontinued | $10.96 | $16.98 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $64.57 Typical High $257.04 | Professional | 54 · Surgery only | $40.74 | $64.57 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.88 Typical High $52.48 | Professional | 55 · Aftercare only | $8.13 | $12.88 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $5.50 | $8.51 | $34.67 |
Where Virginia sits
The same service costs 4.9 times more in Iowa than in Nebraska. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Virginia· 35th of 51
$234
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.